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The Field Guide To Human Error Investigations
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Book Synopsis The Field Guide to Human Error Investigations by : Sidney Dekker
Download or read book The Field Guide to Human Error Investigations written by Sidney Dekker and published by Routledge. This book was released on 2017-11-01 with total page 137 pages. Available in PDF, EPUB and Kindle. Book excerpt: This title was first published in 2002: This field guide assesses two views of human error - the old view, in which human error becomes the cause of an incident or accident, or the new view, in which human error is merely a symptom of deeper trouble within the system. The two parts of this guide concentrate on each view, leading towards an appreciation of the new view, in which human error is the starting point of an investigation, rather than its conclusion. The second part of this guide focuses on the circumstances which unfold around people, which causes their assessments and actions to change accordingly. It shows how to "reverse engineer" human error, which, like any other componant, needs to be put back together in a mishap investigation.
Book Synopsis The Field Guide to Understanding Human Error by : Sidney Dekker
Download or read book The Field Guide to Understanding Human Error written by Sidney Dekker and published by CRC Press. This book was released on 2017-04-07 with total page 250 pages. Available in PDF, EPUB and Kindle. Book excerpt: When faced with a human error problem, you may be tempted to ask 'Why didn't they watch out better? How could they not have noticed?'. You think you can solve your human error problem by telling people to be more careful, by reprimanding the miscreants, by issuing a new rule or procedure. These are all expressions of 'The Bad Apple Theory', where you believe your system is basically safe if it were not for those few unreliable people in it. This old view of human error is increasingly outdated and will lead you nowhere. The new view, in contrast, understands that a human error problem is actually an organizational problem. Finding a 'human error' by any other name, or by any other human, is only the beginning of your journey, not a convenient conclusion. The new view recognizes that systems are inherent trade-offs between safety and other pressures (for example: production). People need to create safety through practice, at all levels of an organization. Breaking new ground beyond its successful predecessor, The Field Guide to Understanding Human Error guides you through the traps and misconceptions of the old view. It explains how to avoid the hindsight bias, to zoom out from the people closest in time and place to the mishap, and resist the temptation of counterfactual reasoning and judgmental language. But it also helps you look forward. It suggests how to apply the new view in building your safety department, handling questions about accountability, and constructing meaningful countermeasures. It even helps you in getting your organization to adopt the new view and improve its learning from failure. So if you are faced by a human error problem, abandon the fallacy of a quick fix. Read this book.
Book Synopsis The Field Guide to Understanding 'Human Error' by : Professor Sidney Dekker
Download or read book The Field Guide to Understanding 'Human Error' written by Professor Sidney Dekker and published by Ashgate Publishing, Ltd.. This book was released on 2014-12-28 with total page 249 pages. Available in PDF, EPUB and Kindle. Book excerpt: This latest edition of The Field Guide to Understanding ‘Human Error' will help you understand how to move beyond 'human error'; how to understand accidents; how to do better investigations; how to understand and improve your safety work. You will be invited to think creatively and differently about the safety issues you and your organization face. In each, you will find possibilities for a new language, for different concepts, and for new leverage points to influence your own thinking and practice, as well as that of your colleagues and organization.
Book Synopsis Patient Safety in Emergency Medicine by : Pat Croskerry
Download or read book Patient Safety in Emergency Medicine written by Pat Croskerry and published by Lippincott Williams & Wilkins. This book was released on 2009 with total page 456 pages. Available in PDF, EPUB and Kindle. Book excerpt: With the increased emphasis on reducing medical errors in an emergency setting, this book will focus on patient safety within the emergency department, where preventable medical errors often occur. The book will provide both an overview of patient safety within health care—the 'culture of safety,' importance of teamwork, organizational change—and specific guidelines on issues such as medication safety, procedural complications, and clinician fatigue, to ensure quality care in the ED. Special sections discuss ED design, medication safety, and awareness of the 'culture of safety.'
Book Synopsis Investigating Human Error by : Barry Strauch
Download or read book Investigating Human Error written by Barry Strauch and published by CRC Press. This book was released on 2017-03-16 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this book the author applies contemporary error theory to the needs of investigators and of anyone attempting to understand why someone made a critical error, how that error led to an incident or accident, and how to prevent such errors in the future. Students and investigators of human error will gain an appreciation of the literature on error, with numerous references to both scientific research and investigative reports in a wide variety of applications, from airplane accidents, to bus accidents, to bonfire disasters. Based on the author's extensive experience as an accident investigator and instructor of both aircraft accident investigation techniques and human factors psychology, it reviews recent human factors literature, summarizes major transportation accidents, and shows how to investigate the types of errors that typically occur in high risk industries. It presents a model of human error causation influenced largely by James Reason and Neville Moray, and relates it to error investigations with step-by-step guidelines for data collection and analysis that investigators can readily apply as needed. This second edition of Investigating Human Error has been brought up to date throughout, with pertinent recent accidents and safety literature integrated. It features new material on fatigue, distraction (eg mobile phone and texting) and medication use. It also now explores the topics of corporate culture, safety culture and safety management systems. Additionally the second edition considers the effects of the reduction in the number of major accidents on investigation quality, the consequences of social changes on transportation safety (such as drinking and driving, cell phone use, etc), the contemporary role of accident investigation, and the effects of the prosecution of those involved in accidents.
Book Synopsis Human Error in Aviation by : R.Key Dismukes
Download or read book Human Error in Aviation written by R.Key Dismukes and published by Routledge. This book was released on 2017-07-05 with total page 608 pages. Available in PDF, EPUB and Kindle. Book excerpt: Most aviation accidents are attributed to human error, pilot error especially. Human error also greatly effects productivity and profitability. In his overview of this collection of papers, the editor points out that these facts are often misinterpreted as evidence of deficiency on the part of operators involved in accidents. Human factors research reveals a more accurate and useful perspective: The errors made by skilled human operators - such as pilots, controllers, and mechanics - are not root causes but symptoms of the way industry operates. The papers selected for this volume have strongly influenced modern thinking about why skilled experts make errors and how to make aviation error resilient.
Book Synopsis Ten Questions About Human Error by : Sidney Dekker
Download or read book Ten Questions About Human Error written by Sidney Dekker and published by CRC Press. This book was released on 2004-12-27 with total page 233 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ten Questions About Human Error asks the type of questions frequently posed in incident and accident investigations, people's own practice, managerial and organizational settings, policymaking, classrooms, Crew Resource Management Training, and error research. It is one installment in a larger transformation that has begun to identify both deep-rooted constraints and new leverage points of views of human factors and system safety. The ten questions about human error are not just questions about human error as a phenomenon, but also about human factors and system safety as disciplines, and where they stand today. In asking these questions and sketching the answers to them, this book attempts to show where current thinking is limited--where vocabulary, models, ideas, and notions are constraining progress. This volume looks critically at the answers human factors would typically provide and compares/contrasts them with current research insights. Each chapter provides directions for new ideas and models that could perhaps better cope with the complexity of the problems facing human error today. As such, this book can be used as a supplement for a variety of human factors courses.
Book Synopsis Human Factors in Transportation by : Katie Plant and Gesa Praetorius
Download or read book Human Factors in Transportation written by Katie Plant and Gesa Praetorius and published by AHFE International. This book was released on 2022-07-24 with total page 763 pages. Available in PDF, EPUB and Kindle. Book excerpt: Human Factors in Transportation Proceedings of the 13th International Conference on Applied Human Factors and Ergonomics (AHFE 2022), July 24–28, 2022, New York, USA
Book Synopsis Rail Human Factors around the World by : John R Wilson
Download or read book Rail Human Factors around the World written by John R Wilson and published by CRC Press. This book was released on 2012-09-13 with total page 870 pages. Available in PDF, EPUB and Kindle. Book excerpt: The rail human factors/ergonomics community has grown quickly and extensively, and there is much increased recognition of the vital importance of ergonomics/human factors by rail infrastructure owners, rail operating companies, system developers, regulators and national and trans-national government. This book, the third on rail human factors, is drawn from papers presented at the Lille 3rd International Conference on Rail Human Factors. The contributions cover the range of human and organisational issues on the railway, from driving to signalling and control to maintenance and engineering work, to passengers and security issues such as trespass, and address improvements in safety, reliability, use of capacity, efficiency and quality. The book represents the best of recent work in rail human factors, and starts to define the framework for the next few years. As well as the human factors areas listed above, the conference and thus the book are notable for sessions on simulation in rail human factors and on human factors in metro design and operation. The book also reflects the increased attention being paid to, and developments in, understanding all aspects of rail stakeholders’ behaviour, and also the contribution of ergonomics/human factors to innovative network control systems which will enhance reliability, safety and use of capacity. The book will be of interest to a number of groups: those working in the rail sector from a human factors point of view; the larger rail industry and related bodies generally; and in terms of transferrable knowledge to ergonomists and human factors specialists working in other industries.
Book Synopsis Human Factors Models for Aviation Accident Analysis and Prevention by : Thomas G.C. Griffin
Download or read book Human Factors Models for Aviation Accident Analysis and Prevention written by Thomas G.C. Griffin and published by Ashgate Publishing, Ltd.. This book was released on 2015-03-28 with total page 236 pages. Available in PDF, EPUB and Kindle. Book excerpt: The investigation and modelling of aviation accident causation is dominated by linear models. Aviation is, however, a complex system and as such suffers from being artificially manipulated into non-complex models and methods. This book addresses this issue by developing a new approach to investigating aviation accident causation through information networks. These networks centralise communication and the flow of information as key indicators of a system’s health and risk. This holistic approach focuses on the system environment, the activity that takes place within it, the strategies used to conduct this activity, the way in which the constituent parts of the system (both human and non-human) interact and the behaviour required. Each stage of this book identifies and expands upon the potential of the information network approach, maintaining firm focus on the overall health of a system. The book’s new model offers many potential developments and some key areas are studied in this research. Through the centralisation of barriers and information nodes the method can be applied to almost any situation. The application of Bayesian mathematics to historical data populations provides scope for studying error migration and barrier manipulation. The book also provides application of these predictions to a flight simulator study for the purposes of validation. Beyond this it also discusses the applicability of the approach to industry. Through working with a legacy airline the methods discussed are used as the basis for a new and prospective safety management system.
Book Synopsis Cause Analysis Manual by : Fred Forck, CPT
Download or read book Cause Analysis Manual written by Fred Forck, CPT and published by Rothstein Publishing. This book was released on 2016-10-05 with total page 342 pages. Available in PDF, EPUB and Kindle. Book excerpt: A failure or accident brings your business to a sudden halt. How did it happen? What’s at the root of the problem? What keeps it from happening again? Good detective work is needed -- but how do you go about it? In this new book, industry pioneer Fred Forck’s seven-step cause analysis methodology guides you to the root of the incident, enabling you to act effectively to avoid loss of time, money, productivity, and quality. From 30+ years of experience as a performance improvement consultant, self-assessment team leader, and trainer, Fred Forck, CPT, understands what you need to get the job done. He leads you through a clear step-by-step process of root cause evaluation, quality improvement, and corrective action. Using these straightforward tools, you can avoid errors, increase reliability, enhance performance, and improve bottom-line results -- while creating a resilient culture that avoids repeat failures. The key phases of this successful cause analysis include: Scoping the Problem Investigating the Factors Reconstructing the Story Establishing Contributing Factors Validating Underlying Factors Planning Corrective Actions Reporting Learnings At each stage, Cause Analysis Manual: Incident Investigation Method and Techniques gives you a wealth of real-world examples, models, thought-provoking discussion questions, and ready-to-use checklists and forms. The author provides: references for further reading hundreds of illustrative figures, tables, and diagrams a full glossary of terms and acronyms professional index You know that identifying causes and preventing business-disrupting events isn’t always easy. By following Fred Forck’s proven steps you will be able to identify contributing factors, align organizational behaviors, take corrective action, and improve business performance! Are you a professor or leader of seminars or workshops? On confirmed course adoption of Cause Analysis Manual: Incident Investigation Method and Techniques, you will have access to a comprehensive, professional Instructor’s Manual.
Book Synopsis Second Workshop on the Investigation and Reporting of Incidents and Accidents, IRIA 2003 by :
Download or read book Second Workshop on the Investigation and Reporting of Incidents and Accidents, IRIA 2003 written by and published by . This book was released on 2003 with total page 258 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Aviation Psychology: Practice and Research by : Klaus-Martin Goeters
Download or read book Aviation Psychology: Practice and Research written by Klaus-Martin Goeters and published by Routledge. This book was released on 2017-03-02 with total page 393 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the well-established aviation system, the importance of sound human factors practice, based on good aviation psychology research, is obvious from those incidents and accidents resulting from its neglect. This carefully structured book presents an up-to-date review of the main areas in the field of Aviation Psychology. It contains current thinking mainly from Europe, but with input from Australia and North America, from specialists involved in research, training and operational practice. Spanning six parts, the book covers: Human Engineering, Occupational Demands, Selection of Aviation Personnel, Human Factors Training, Clinical Psychology, Accident Investigation and Prevention. Looking at the six parts - in human engineering, the reader learns about human-centered automation as well as human factors issues in aircraft certification. Results derived by job analysis methods are presented in the next part and serve as basic information in the design of selection and training programs. In selection, computerized testing or behaviour-oriented assessments are challenging approaches for personnel recruitment. Cost-benefit analyses in selection reveal convincing results, enabling organizations to save huge amounts of inappropriate training investment by the application of proper selection tests. The NOTECHS method is described which helps to assess CRM capabilities in training and can also be used to measure training effects in systematic validation studies. Although operational personnel in aviation are usually able to cope with stress more efficiently than other occupational groups, individual problems might develop as reactions to traumatic influences. Either a psychological evaluation or a proper treatment or both is then required as described in the 'Clinical Psychology' part of the book. The readership includes: aviation psychologists and flight surgeons, training, selection and recruitment specialists, instructor pilots, CRM facilitators, personnel managers, accident investigators, safety pilots, air traffic controllers, aircraft engineers and those dealing with human-machine interfaces.
Book Synopsis The Field Guide to Understanding Human Error by : Dekker Sidney
Download or read book The Field Guide to Understanding Human Error written by Dekker Sidney and published by Ashgate Publishing. This book was released on 2006 with total page 236 pages. Available in PDF, EPUB and Kindle. Book excerpt: When faced with a human error problem, you may be tempted to ask 'Why didn't they watch out better? How could they not have noticed?'. You think you can solve your human error problem by telling people to be more careful, by reprimanding the miscreants, by issuing a new rule or procedure. These are all expressions of 'The Bad Apple Theory', where you believe your system is basically safe if it were not for those few unreliable people in it. This old view of human error is increasingly outdated and will lead you nowhere. The new view, in contrast, understands that a human error problem is actually an organizational problem. Finding a 'human error' by any other name, or by any other human, is only the beginning of your journey, not a convenient conclusion. The new view recognizes that systems are inherent trade-offs between safety and other pressures (for example: production). People need to create safety through practice, at all levels of an organization. Breaking new ground beyond its successful predecessor, The Field Guide to Understanding Human Error guides you through the traps and misconceptions of the old view. It explains how to avoid the hindsight bias, to zoom out from the people closest in time and place to the mishap, and resist the temptation of counterfactual reasoning and judgmental language. But it also helps you look forward. It suggests how to apply the new view in building your safety department, handling questions about accountability, and constructing meaningful countermeasures. It even helps you in getting your organization to adopt the new view and improve its learning from failure. So if you are faced by a human error problem, abandon the fallacy of a quick fix. Read this book.
Book Synopsis Causal Factors Analysis by : Babcock & Wilcox Technical Services Pantex
Download or read book Causal Factors Analysis written by Babcock & Wilcox Technical Services Pantex and published by Government Printing Office. This book was released on 2008 with total page 276 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Controller written by and published by . This book was released on 2001 with total page 446 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Decision Making in Aviation by : Don Harris
Download or read book Decision Making in Aviation written by Don Harris and published by Routledge. This book was released on 2017-07-05 with total page 691 pages. Available in PDF, EPUB and Kindle. Book excerpt: Decision making pervades every aspect of life: people make hundreds of decisions every day. The vast majority of these are trivial and without a right or wrong answer. In some respects there is also nothing extraordinary about pilot decision making. It is only the setting that is different - the underlying cognitive processes are just the same. However, it is the context and the consequences of a poor decision which serve to differentiate aeronautical decision making. Decisions on the flight deck are often made with incomplete information and while under time pressure. The implications for inadequate performance is much more serious than in many other professions. Poor decisions are implicated in over half of all aviation accidents. This volume contains key papers published over the last 25 years providing an overview of the major paradigms by which aeronautical decision making has been investigated. Furthermore, decision making does not occur in isolation. It is a joint function of the flight tasks; knowledge; equipment on the flight deck and other stressors. In this volume of collected papers, works from leading authors in the field consider all these aspects of aeronautical decision making.
